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General NPI Number Information
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NPI Number | 1992187355
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Entity Type | Individual
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Provider Name | TAYLOR WHITNEY WEAVER
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Gender | Female
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Dates
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Enumeration Date | 06/22/2015
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Last Update Date | 01/27/2023
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Provider Practice Location Address
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Address Line | 4445 EASTGATE MALL STE 200
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City | SAN DIEGO
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State | CA
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Zip | 92121-1979
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Country | US
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Telephone | 888-874-3314
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1310
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City | SHERWOOD
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State | OR
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Zip | 97140-1310
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Country | US
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Telephone | 619-340-5711
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 102423
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License Number State | CA
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